Individual provider Active NPI

Stephen J Burds, D.D.S.

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1154460863
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8102 Issued in IA
Practice address
1540 High St
Suite 201
Des Moines, IA 50309-3106
Phone
(515) 244-9565
Fax
(515) 288-7239
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8102 IA Primary

Addresses

Primary practice location

1540 High St
Suite 201
Des Moines, IA 50309-3106

Mailing address

1540 High St
Suite 201
Des Moines, IA 50309-3106
Phone (515) 244-9565

Other identifiers 1

IdentifierTypeStateIssuer
1154460863MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002625 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224353560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8102IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Tight Appliances PastSince Mar 28, 2014 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1154460863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 HIGH ST",
            "address_2": "SUITE 201",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093106",
            "telephone_number": "515-244-9565",
            "fax_number": "515-288-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 HIGH ST",
            "address_2": "SUITE 201",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093106",
            "telephone_number": "515-244-9565",
            "fax_number": "515-288-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDS",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154460863",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.